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Cannabis Policies, Use Patterns, and Research Vary Dramatically Across 16 Countries

ReviewModerate evidence
The takeaway

A review across 16 countries found inconsistent cannabis use reporting, wide variation in legalization policies and intervention strategies, with European countries dominating research output while Asian countries contributed far less.

International policy researchers; WHO and UN drug policy advisors; public health officials in countries considering cannabis reform.

European countries dominated cannabis research; Asian countries significantly underrepresented

What the researchers found

Cannabis use prevalence reporting was inconsistent across countries. Policies ranged from full legalization to strict prohibition. Intervention strategies varied widely. European countries dominated PubMed-indexed cannabis research, while Asian countries (Thailand, Malaysia, India, Iran, Nepal) contributed much less despite significant cannabis use.

Why it matters

Global cannabis policy is evolving rapidly, but without consistent data across countries, it is difficult to learn from different approaches. The heterogeneity identified here suggests that global coordination is needed to prevent disproportionate harms.

The numbers in context

16 countries reviewed. PubMed search covered 2010-2020. European countries produced the most cannabis research. Asian countries were significantly underrepresented in research despite substantial cannabis use populations.

How the study worked

Systematic search of PubMed and Google Scholar (2010-2020) plus government websites in 16 countries, using country-specific search terms in English and local languages. Compared cannabis use patterns, policies, and research output across countries.

What this study cannot tell us

The review covered only 16 of nearly 200 countries. English-language search bias may undercount non-English research. The 2010-2020 timeframe misses more recent policy changes. Qualitative synthesis limits comparability.

How to read the evidence

Moderate: multi-country review with systematic methodology, though limited to 16 countries and qualitative synthesis.

When this study was published

Published in 2022, covering literature from 2010-2020.

The bigger picture

As more countries consider cannabis reform, cross-country learning is critical. But this review reveals that the evidence base is geographically skewed, meaning policy decisions in underresearched regions may rely on data from very different cultural and regulatory contexts.

Questions still open

  • Would standardized cannabis monitoring across countries improve global evidence? How can underresearched regions build cannabis research capacity? Do different policy approaches lead to measurably different health outcomes?

Common questions

Which countries have legalized cannabis?
The review found a spectrum from full legalization to strict prohibition across the 16 countries studied. The variation in approaches reflects different cultural attitudes, public health concerns, and political contexts.
Why does cannabis research vary so much across countries?
Research output reflects funding availability, legal restrictions on cannabis research, academic infrastructure, and policy priorities. Countries with strict prohibition may discourage research, while those with legalization may actively fund it.

Read the original research

Current state of cannabis use, policies, and research across sixteen countries: cross-country comparisons and international perspectives.

Trends in psychiatry and psychotherapy, 44(Suppl 1), e20210263

Citation

Ransing, Ramdas; de la Rosa, Pedro A; Pereira-Sanchez, Victor; Handuleh, Jibril I M; Jerotic, Stefan; Gupta, Anoop Krishna; Karaliuniene, Ruta; de Filippis, Renato; Peyron, Eric; Sönmez Güngör, Ekin; Boujraf, Said; Yee, Anne; Vahdani, Bita; Shoib, Sheikh; Stowe, M J; Jaguga, Florence; Dannatt, Lisa; da Silva, Alexandre Kieslich; Grandinetti, Paolo; Jatchavala, Chonnakarn. (2022). Current state of cannabis use, policies, and research across sixteen countries: cross-country comparisons and international perspectives.. Trends in psychiatry and psychotherapy, 44(Suppl 1), e20210263. https://doi.org/10.47626/2237-6089-2021-0263

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